Individual
JUSTIN CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
73181
WI
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
73181
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174903645
—
WI
Enumeration date
05/31/2015
Last updated
11/04/2022
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